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Article(id=1241034444023329107, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202503018, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1740758400000, receivedDateStr=2025-03-01, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815268760, onlineDateStr=2026-03-18, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815268760, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815268760, creator=13701087609, updateTime=1773815268760, updator=13701087609, issue=Issue{id=1241034441380917539, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815268130, creator=13701087609, updateTime=1773815340947, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241034746873049765, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241034746873049766, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2107, endPage=2112, ext={EN=ArticleExt(id=1241034444409205094, articleId=1241034444023329107, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the prevalence and influencing factors of dyslipidemia among 110 000 elderly residents in Pidu district, Chengdu, columnId=1228016569138213037, journalTitle=Modern Preventive Medicine, columnName=Clinical Medicine and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the prevalence of dyslipidemia and its influencing factors among the elderly in Pidu District.

Methods

An analysis was conducted on health examination data from permanent residents aged 65 and older in Pidu District from 2022 to 2023. The comparison of rates was performed using the chi-square test, and multivariate logistic regression analysis was employed to explore the risk factors associated with dyslipidemia. The significance level was set at α=0.05.

Results

A total of 110 992 elderly individuals completed all examination items in Pidu District during 2022 and 2023, including 48 956 males (44.1%) and 62 036 females (55.9%), with an average age of (71.9±5.9) years. The detection rates of dyslipidemia, elevated total cholesterol (TC), elevated triglycerides (TG), elevated low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C) were 30.3%, 16.1%, 15.5%, 7.3%, and 5.6%, respectively. Female gender (OR=1.48, 95%CI: 1.43-1.54),smoking (OR=1.09, 95%CI: 1.04-1.14), overweight (OR=1.97, 95%CI: 1.80-2.16), obesity (OR=2.05, 95%CI: 1.86-2.26), central obesity (OR=1.23, 95%CI: 1.19-1.27), and lack of exercise (OR=1.18, 95%CI: 1.14-1.22) were identified as risk factors for dyslipidemia among the elderly in Pidu District. Conversely, being a rural resident (OR=0.84, 95%CI: 0.81-0.86) and being aged 80 years or older (OR=0.76, 95%CI: 0.73-0.79) were identified as protective factors.

Conclusion

It is essential to implement gender-sensitive management for the elderly, enhance health education related to overweight, obesity, and central obesity, and strengthen weight management among the elderly, while promoting daily exercise and smoking cessation.

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目的

探究郫都区老年人血脂异常患病率及其影响因素。

方法

对郫都区65岁及以上常住居民2022—2023年健康体检数据进行分析。率的比较采用χ2检验，探索血脂异常相关危险因素采用多因素logistic回归分析。检验水准α=0.05。

结果

2022—2023年郫都区完成所有体检项目老年人累积110 992人，其中男性48 956（44.1%）人，女性62 036（55.9%）人，平均年龄（71.9±5.9）岁。血脂异常、总胆固醇升高、甘油三酯升高、低密度脂蛋白胆固醇升高、高密度脂蛋白胆固醇降低的检出率分别为30.3%、16.1%、15.5%、7.3%、5.6%。女性（OR=1.48，95%CI:1.43～1.54）、吸烟（OR=1.09，95%CI:1.04～1.14）、超重（OR=1.97，95%CI:1.80～2.16）、肥胖（OR=2.05，95%CI:1.86～2.26）、中心性肥胖（OR=1.23，95%CI:1.19～1.27）、不锻炼（OR=1.18，95%CI:1.14～1.22）是郫都区老年人血脂异常的危险因素，农村居民（OR=0.84，95%CI:0.81～0.86）、年龄≥80岁（OR=0.76，95%CI:0.73～0.79）是保护因素。

结论

应对老年人进行性别差异性管理，同时加强超重肥胖及中心性肥胖相关的健康教育，强化老年人体重管理，每日锻炼、戒烟限酒。

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江秀，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=a3repcJFrDjktgp07smLaw==, magXml=H/Yzj9VxR7G1rWS4osp3Fg==, pdfUrl=null, pdf=cL0ud7I4wP5z1PNU+SkI6A==, pdfFileSize=607772, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=gW41tNhdbFRVETEORmVPeg==, mapNumber=null, authorCompany=null, fund=null, authors=

李秋佳（1995—），女，本科，主管医师，研究方向：疾病预防控制方向

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Detection and univariate analysis of dyslipidemia in different population groups ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
人群特征人数血脂异常
合计TC升高TG升高LDL-C升高HDL-C降低
性别男48 95612 546(25.6)5 384(11.0)6 260(12.8)2 801(5.7)3 720(7.6)
女62 03621 116(34.0)12 456(20.1)10 975(17.7)5 298(8.5)2 441(3.9)
χ2值916.151 672.72501.75321.39700.60
P值<0.001<0.001<0.001<0.001<0.001
年龄（岁）60～6946 79815 176(32.4)8 114(17.3)7 909(16.9)3 838(8.2)2 628(5.6)
70～7950 86815 075(29.6)7 920(15.6)7 765(15.3)3 459(6.8)2 807(5.5)
≥8013 3263 411(25.6)1 806(13.6)1 561(11.7)802(6.0)726(5.4)
χ2值250.46129.70227.49107.630.74
P值<0.001<0.001<0.001<0.0010.689
城乡城市78 20424 685(31.6)12 830(16.4)12 255(15.7)6 396(8.2)5 112(6.5)
农村32 7888 977(27.4)5 010(15.3)4 980(15.2)1 703(5.2)1 049(3.2)
χ2值191.5721.704.09304.23490.81
P值<0.001<0.0010.043<0.001<0.001
吸烟从不78 75525 203(32.0)13 997(17.8)12 799(16.3)6 367(8.1)3 987(5.1)
戒烟13 5523 604(26.6)1 671(12.3)1 724(12.7)808(6.0)1 001(7.4)
吸烟18 6854 855(26.0)2 172(11.6)2 712(14.5)924(4.9)1 173(6.3)
χ2值360.75583.54127.46260.69141.74
P值<0.001<0.001<0.001<0.001<0.001
饮酒从不75 54524 010(31.8)13 092(17.3)12 302(16.3)5 927(7.8)4 016(5.3)
偶尔17 6965 088(28.8)2 450(13.8)2 498(14.1)1 221(6.9)1 263(7.1)
经常4 2151 137(27.0)629(14.9)566(13.4)248(5.9)200(4.7)
每天13 5363 427(25.3)1 669(12.3)1 869(13.8)703(5.2)682(5.0)
χ2值279.65298.32104.54138.72104.88
P值<0.001<0.001<0.001<0.001<0.001
运动每天80 60325 307(31.4)13 483(16.7)12 793(15.9)6 411(8.0)4 686(5.8)
偶尔6 3781 938(30.4)1 026(16.1)1 069(16.8)411(6.4)305(4.8)
不锻炼24 0116417(26.7)3 331(13.9)3 373(14.0)1 277(5.3)1 170(4.9)
χ2值191.12111.9954.84197.3138.87
P值<0.001<0.001<0.001<0.001<0.001
BMI 消瘦3 229613(19.0)489(15.1)112(3.5)154(4.8)49(1.5)
标准50 41212 925(25.6)7 901(15.7)5 425(10.8)3 328(6.6)1 930(3.8)
超重42 66514 590(34.2)7 062(16.6)8 214(19.3)3 443(8.1)2 939(6.9)
肥胖14 6865 534(37.7)2 388(16.3)3 484(23.7)1 174(8.0)1 243(8.5)
χ2值1 399.3415.692 434.37114.75768.77
P值<0.0010.001<0.001<0.001<0.001
中心性肥胖正常74 30420 139(27.1)11 632(15.7)9 116(12.3)5 055(6.8)3 259(4.4)
超标36 68813 523(36.9)6 208(16.9)8 119(22.1)3 044(8.3)2 902(7.9)
χ2值1 106.3129.201 820.8981.02581.74
P值<0.001<0.001<0.001<0.001<0.001
自理评估可自理109 48033 216(30.3)17 652(16.1)16 985(15.5)8 006(7.3)6 032(5.5)
轻度依赖550150(27.3)63(11.5)81(14.7)23(4.2)45(8.2)
中度依赖28889(30.9)35(12.2)42(14.6)22(7.6)31(10.8)
不能自理19653(27.0)18(9.2)24(12.2)10(5.1)24(12.2)
χ2值3.4819.072.039.3739.31
P值0.323<0.0010.5650.025<0.001
), ArticleFig(id=1241050834033767136, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034444023329107, language=CN, label=表1, caption=

不同类别人群血脂异常检出情况及单因素分析［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
人群特征人数血脂异常
合计TC升高TG升高LDL-C升高HDL-C降低
性别男48 95612 546(25.6)5 384(11.0)6 260(12.8)2 801(5.7)3 720(7.6)
女62 03621 116(34.0)12 456(20.1)10 975(17.7)5 298(8.5)2 441(3.9)
χ2值916.151 672.72501.75321.39700.60
P值<0.001<0.001<0.001<0.001<0.001
年龄（岁）60～6946 79815 176(32.4)8 114(17.3)7 909(16.9)3 838(8.2)2 628(5.6)
70～7950 86815 075(29.6)7 920(15.6)7 765(15.3)3 459(6.8)2 807(5.5)
≥8013 3263 411(25.6)1 806(13.6)1 561(11.7)802(6.0)726(5.4)
χ2值250.46129.70227.49107.630.74
P值<0.001<0.001<0.001<0.0010.689
城乡城市78 20424 685(31.6)12 830(16.4)12 255(15.7)6 396(8.2)5 112(6.5)
农村32 7888 977(27.4)5 010(15.3)4 980(15.2)1 703(5.2)1 049(3.2)
χ2值191.5721.704.09304.23490.81
P值<0.001<0.0010.043<0.001<0.001
吸烟从不78 75525 203(32.0)13 997(17.8)12 799(16.3)6 367(8.1)3 987(5.1)
戒烟13 5523 604(26.6)1 671(12.3)1 724(12.7)808(6.0)1 001(7.4)
吸烟18 6854 855(26.0)2 172(11.6)2 712(14.5)924(4.9)1 173(6.3)
χ2值360.75583.54127.46260.69141.74
P值<0.001<0.001<0.001<0.001<0.001
饮酒从不75 54524 010(31.8)13 092(17.3)12 302(16.3)5 927(7.8)4 016(5.3)
偶尔17 6965 088(28.8)2 450(13.8)2 498(14.1)1 221(6.9)1 263(7.1)
经常4 2151 137(27.0)629(14.9)566(13.4)248(5.9)200(4.7)
每天13 5363 427(25.3)1 669(12.3)1 869(13.8)703(5.2)682(5.0)
χ2值279.65298.32104.54138.72104.88
P值<0.001<0.001<0.001<0.001<0.001
运动每天80 60325 307(31.4)13 483(16.7)12 793(15.9)6 411(8.0)4 686(5.8)
偶尔6 3781 938(30.4)1 026(16.1)1 069(16.8)411(6.4)305(4.8)
不锻炼24 0116417(26.7)3 331(13.9)3 373(14.0)1 277(5.3)1 170(4.9)
χ2值191.12111.9954.84197.3138.87
P值<0.001<0.001<0.001<0.001<0.001
BMI 消瘦3 229613(19.0)489(15.1)112(3.5)154(4.8)49(1.5)
标准50 41212 925(25.6)7 901(15.7)5 425(10.8)3 328(6.6)1 930(3.8)
超重42 66514 590(34.2)7 062(16.6)8 214(19.3)3 443(8.1)2 939(6.9)
肥胖14 6865 534(37.7)2 388(16.3)3 484(23.7)1 174(8.0)1 243(8.5)
χ2值1 399.3415.692 434.37114.75768.77
P值<0.0010.001<0.001<0.001<0.001
中心性肥胖正常74 30420 139(27.1)11 632(15.7)9 116(12.3)5 055(6.8)3 259(4.4)
超标36 68813 523(36.9)6 208(16.9)8 119(22.1)3 044(8.3)2 902(7.9)
χ2值1 106.3129.201 820.8981.02581.74
P值<0.001<0.001<0.001<0.001<0.001
自理评估可自理109 48033 216(30.3)17 652(16.1)16 985(15.5)8 006(7.3)6 032(5.5)
轻度依赖550150(27.3)63(11.5)81(14.7)23(4.2)45(8.2)
中度依赖28889(30.9)35(12.2)42(14.6)22(7.6)31(10.8)
不能自理19653(27.0)18(9.2)24(12.2)10(5.1)24(12.2)
χ2值3.4819.072.039.3739.31
P值0.323<0.0010.5650.025<0.001
), ArticleFig(id=1241050834230899438, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034444023329107, language=EN, label=Table 2, caption=

Multivariate logistic regression analysis of dyslipidemia-related factors [OR (95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素对照组血脂异常
合计TC升高TG升高LDL-C升高HDL-C降低
年龄（岁）70～7960～690.88(0.86～0.91)0.88(0.85～0.91)0.89(0.86～0.93)0.82(0.79～0.87)—
≥800.76(0.73～0.79)0.77(0.73～0.81)0.72(0.67～0.76)0.76(0.70～0.82)—
性别女男1.48(1.43～1.54)2.33(2.21～2.45)1.52(1.44～1.59)1.38(1.29～1.48)0.37(0.34～0.39)
自理评估轻度依赖能自理—0.75(0.58～0.98)——1.63(1.19～2.23)
中度依赖—2.23(1.52～3.28)
不能自理————2.70(1.73～4.23)
运动频率不锻炼每天1.18(1.14～1.22)1.19(1.14～1.24)1.10(1.06～1.15)1.39(1.31～1.48)1.11(1.04～1.19)
偶尔1.13(1.06～1.20)1.13(1.04～1.22)1.14(1.05～1.24)1.17(1.04～1.32)—
吸烟戒烟从不吸烟—1.09(1.02～1.17)—0.89(0.81～0.98)
吸烟1.09(1.04～1.14)—1.34(1.26～1.43)0.81(0.74～0.89)—
饮酒偶尔从不饮酒—1.13(1.07～1.20)0.93(0.88～0.98)—0.78(0.72～0.84)
经常—1.44(1.30～1.58)—0.53(0.46～0.62)
每天0.93(0.89～0.98)1.18(1.10～1.26)——0.55(0.50～0.61)
BMI 正常消瘦1.43(1.31～1.57)—3.24(2.68～3.92)1.35(1.14～1.59)2.41(1.81～3.21)
超重1.97(1.80～2.16)5.61(4.63～6.79)1.58(1.34～1.87)3.87(2.90～5.16)
肥胖2.05(1.86～2.26)6.27(5.15～7.62)1.46(1.22～1.75)4.39(3.27～5.90)
中心性肥胖中心性肥胖正常1.23(1.19～1.27)—1.39(1.33～1.45)1.09(1.03～1.15)1.56(1.47～1.67)
城乡农村城市0.84(0.81～0.86)0.93(0.90～0.97)—0.65(0.62～0.69)0.50(0.47～0.53)
), ArticleFig(id=1241050834474169083, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034444023329107, language=CN, label=表2, caption=

血脂异常相关因素的多因素logistic回归分析[OR值(95%CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
影响因素对照组血脂异常
合计TC升高TG升高LDL-C升高HDL-C降低
年龄（岁）70～7960～690.88(0.86～0.91)0.88(0.85～0.91)0.89(0.86～0.93)0.82(0.79～0.87)—
≥800.76(0.73～0.79)0.77(0.73～0.81)0.72(0.67～0.76)0.76(0.70～0.82)—
性别女男1.48(1.43～1.54)2.33(2.21～2.45)1.52(1.44～1.59)1.38(1.29～1.48)0.37(0.34～0.39)
自理评估轻度依赖能自理—0.75(0.58～0.98)——1.63(1.19～2.23)
中度依赖—2.23(1.52～3.28)
不能自理————2.70(1.73～4.23)
运动频率不锻炼每天1.18(1.14～1.22)1.19(1.14～1.24)1.10(1.06～1.15)1.39(1.31～1.48)1.11(1.04～1.19)
偶尔1.13(1.06～1.20)1.13(1.04～1.22)1.14(1.05～1.24)1.17(1.04～1.32)—
吸烟戒烟从不吸烟—1.09(1.02～1.17)—0.89(0.81～0.98)
吸烟1.09(1.04～1.14)—1.34(1.26～1.43)0.81(0.74～0.89)—
饮酒偶尔从不饮酒—1.13(1.07～1.20)0.93(0.88～0.98)—0.78(0.72～0.84)
经常—1.44(1.30～1.58)—0.53(0.46～0.62)
每天0.93(0.89～0.98)1.18(1.10～1.26)——0.55(0.50～0.61)
BMI 正常消瘦1.43(1.31～1.57)—3.24(2.68～3.92)1.35(1.14～1.59)2.41(1.81～3.21)
超重1.97(1.80～2.16)5.61(4.63～6.79)1.58(1.34～1.87)3.87(2.90～5.16)
肥胖2.05(1.86～2.26)6.27(5.15～7.62)1.46(1.22～1.75)4.39(3.27～5.90)
中心性肥胖中心性肥胖正常1.23(1.19～1.27)—1.39(1.33～1.45)1.09(1.03～1.15)1.56(1.47～1.67)
城乡农村城市0.84(0.81～0.86)0.93(0.90～0.97)—0.65(0.62～0.69)0.50(0.47～0.53)
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成都市郫都区11万常住老年人血脂异常患病率及影响因素分析
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李秋佳 , 江秀 , 谢天
现代预防医学 | 临床与预防 2025,52(11): 2107-2112
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现代预防医学 | 临床与预防 2025, 52(11): 2107-2112
成都市郫都区11万常住老年人血脂异常患病率及影响因素分析
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李秋佳, 江秀 , 谢天
作者信息
  • 成都市郫都区疾病预防控制中心，四川 成都 611730

    • 李秋佳（1995—），女，本科，主管医师，研究方向：疾病预防控制方向

通讯作者:

江秀，E-mail:
Analysis of the prevalence and influencing factors of dyslipidemia among 110 000 elderly residents in Pidu district, Chengdu
Qiu-jia LI, Xiu JIANG , Tian XIE
Affiliations
  • Chengdu Pidu District Center for Disease Control and Prevention, Chengdu, Sichuan 611730, China
出版时间: 2025-06-10 doi: 10.20043/j.cnki.MPM.202503018
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摘要
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目的

探究郫都区老年人血脂异常患病率及其影响因素。

方法

对郫都区65岁及以上常住居民2022—2023年健康体检数据进行分析。率的比较采用χ2检验，探索血脂异常相关危险因素采用多因素logistic回归分析。检验水准α=0.05。

结果

2022—2023年郫都区完成所有体检项目老年人累积110 992人，其中男性48 956（44.1%）人，女性62 036（55.9%）人，平均年龄（71.9±5.9）岁。血脂异常、总胆固醇升高、甘油三酯升高、低密度脂蛋白胆固醇升高、高密度脂蛋白胆固醇降低的检出率分别为30.3%、16.1%、15.5%、7.3%、5.6%。女性（OR=1.48，95%CI:1.43～1.54）、吸烟（OR=1.09，95%CI:1.04～1.14）、超重（OR=1.97，95%CI:1.80～2.16）、肥胖（OR=2.05，95%CI:1.86～2.26）、中心性肥胖（OR=1.23，95%CI:1.19～1.27）、不锻炼（OR=1.18，95%CI:1.14～1.22）是郫都区老年人血脂异常的危险因素，农村居民（OR=0.84，95%CI:0.81～0.86）、年龄≥80岁（OR=0.76，95%CI:0.73～0.79）是保护因素。

结论

应对老年人进行性别差异性管理，同时加强超重肥胖及中心性肥胖相关的健康教育，强化老年人体重管理，每日锻炼、戒烟限酒。

血脂异常  /  老年人  /  横断面研究
Objective

To investigate the prevalence of dyslipidemia and its influencing factors among the elderly in Pidu District.

Methods

An analysis was conducted on health examination data from permanent residents aged 65 and older in Pidu District from 2022 to 2023. The comparison of rates was performed using the chi-square test, and multivariate logistic regression analysis was employed to explore the risk factors associated with dyslipidemia. The significance level was set at α=0.05.

Results

A total of 110 992 elderly individuals completed all examination items in Pidu District during 2022 and 2023, including 48 956 males (44.1%) and 62 036 females (55.9%), with an average age of (71.9±5.9) years. The detection rates of dyslipidemia, elevated total cholesterol (TC), elevated triglycerides (TG), elevated low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C) were 30.3%, 16.1%, 15.5%, 7.3%, and 5.6%, respectively. Female gender (OR=1.48, 95%CI: 1.43-1.54),smoking (OR=1.09, 95%CI: 1.04-1.14), overweight (OR=1.97, 95%CI: 1.80-2.16), obesity (OR=2.05, 95%CI: 1.86-2.26), central obesity (OR=1.23, 95%CI: 1.19-1.27), and lack of exercise (OR=1.18, 95%CI: 1.14-1.22) were identified as risk factors for dyslipidemia among the elderly in Pidu District. Conversely, being a rural resident (OR=0.84, 95%CI: 0.81-0.86) and being aged 80 years or older (OR=0.76, 95%CI: 0.73-0.79) were identified as protective factors.

Conclusion

It is essential to implement gender-sensitive management for the elderly, enhance health education related to overweight, obesity, and central obesity, and strengthen weight management among the elderly, while promoting daily exercise and smoking cessation.

Dyslipidemia  /  Elderly  /  Cross-sectional study
李秋佳, 江秀, 谢天. 成都市郫都区11万常住老年人血脂异常患病率及影响因素分析. 现代预防医学, 2025 , 52 (11) : 2107 -2112 . DOI: 10.20043/j.cnki.MPM.202503018
Qiu-jia LI, Xiu JIANG, Tian XIE. Analysis of the prevalence and influencing factors of dyslipidemia among 110 000 elderly residents in Pidu district, Chengdu[J]. Modern Preventive Medicine, 2025 , 52 (11) : 2107 -2112 . DOI: 10.20043/j.cnki.MPM.202503018
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近几十年来，中国人群的血脂水平、血脂异常患病率明显增加[1]。血脂异常是冠状动脉粥样硬化性心脏病、心肌梗死、缺血性脑卒中等心脑血管疾病的重要危险因素[2-3]。了解老年人血脂异常流行情况，并积极采取健康管理措施实施控制，对于促进老年人健康具有重要意义。本研究对郫都区11万常住老年人体检数据进行分析，探究老年人血脂异常患病率及其影响因素。
1　对象与方法
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1.1　对象
成都市郫都区65岁及以上常住居民（当地居住6个月及以上）。2022—2023年，全区7个社区卫生服务中心及3个乡镇卫生院对65岁及以上常住居民进行健康体检，体检率（体检人数/全区老年人口数*100%）达64%。本研究所有研究对象均签署知情同意书；使用数据为《国家基本公共卫生服务规范（第三版）》明确规定内容的历史存档匿名数据，已完全去除个人标识信息。
1.2　调查方法
采用《国家基本公共卫生服务规范（第三版）》统一问卷及体检表，由经统一规范化培训的医护人员对研究对象进行面对面生活方式和健康状况评估、体格检查、辅助检查和健康指导，并收集研究对象体格检查及血液生化检验结果。
1.3　资料来源
体检数据来自“基本公共卫生服务信息系统”数据导出，排除未完成血液检查及问卷调查数据。
1.4　指标定义
（1）根据《中国成人血脂异常防治指南（2016年修订版）》[4]确定血脂异常标准：总胆固醇升高（total cholesterol, TC≥6.2 mmol/L）或甘油三酯升高（triglycerides, TG≥2.3 mmol/L）或低密度脂蛋白胆固醇升高（low-density lipoprotein cholesterol, LDL-C≥4.1 mmol/L）或高密度脂蛋白胆固醇降低（high-density lipoprotein cholesterol, HDL-C<1.0 mmol/L），本研究中定义血脂异常是指上述四个指标中存在一项及以上异常；（2）根据《中国2型糖尿病防治指南（2020年版）》[5]确定中心性肥胖标准：成年女性腰围≥85cm,成年男性腰围≥90cm；（3）根据《中国成人超重和肥胖症预防控制指南（2021年版）》[6]确定身体质量指数（BMI）标准：BMI=体重（kg）/身高的二次方（m2），BMI<18.5 kg/m2为体重过轻、18.5 kg/m2≤BMI<24 kg/m2为正常、24 kg/m2≤BMI<28 kg/m2为超重、BMI≥28 kg/m2为肥胖。（4）根据《国家基本公共卫生服务规范（第三版）》中的《老年人生活自理能力评估表》[7]确定自理能力标准：根据进餐、梳洗、穿衣、如厕、活动五个方面进行评估，各方面评分汇总后，0～3分为可自理、4～8分为轻度依赖、9～18分为中度依赖、≥19分为生活不能自理。
1.5　统计方法
使用Excel 2010软件进行数据整理，采用SPSS 20.0统计软件进行数据分析，血脂异常率的比较采用χ2检验及趋势χ2检验，探索血脂异常相关危险因素采用多因素logistic回归分析。检验水准α=0.05。
2　结果
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2.1　调查对象总体情况
2022—2023年郫都区完成所有体检项目老年人累积110 992人，其中男性48 956（44.1%）人，女性62 036（55.9%）人；城市居民78 204（70.5%）人，农村居民32 788（29.5%）人；平均年龄（71.9±5.9）岁。
2.2　血脂异常检出情况及单因素分析
本次调查血脂异常检出率为30.3%，其中TC升高、TG升高、LDL-C升高、HDL-C降低检出率分别为16.1%、15.5%、7.3%、5.6%。女性的血脂异常检出率为34.0%，高于男性的25.6%（P<0.001）；城市居民的血脂异常检出率为31.6%，高于农村居民的27.4%（P<0.001）；中心性肥胖居民的血脂异常检出率为36.9%，高于正常体型居民的27.1%（P<0.001），每天饮酒的居民血脂异常检出率为25.3%，低于从不饮酒的居民的31.8%（P<0.001）；随着BMI的等级增加血脂异常检出率增高（χ2趋势=1 399.34，P<0.001）；随着年龄的增加血脂异常检出率降低（χ2趋势=250.46，P<0.001）。不同吸烟史、运动情况、自理情况的居民血脂异常检出率差异有统计学意义（P<0.05）。见表1。
2.3　多因素logistic回归分析
以血脂异常、TC升高、TG升高、LDL-C升高、HDL-C降低作为因变量（0=否，1=是），以单因素χ2分析的性别、年龄、城乡、吸烟、饮酒、运动、BMI、中心性肥胖、自理评估等为自变量进行多因素logistic回归分析。结果显示，女性（OR=1.48，95%CI:1.43～1.54）、吸烟（OR=1.09，95%CI:1.04～1.14）、超重（OR=1.97，95%CI:1.80～2.16）、肥胖（OR=2.05，95%CI:1.86～2.26）、中心性肥胖（OR=1.23，95%CI:1.19～1.27）、不锻炼（OR=1.18，95%CI:1.14～1.22）是血脂异常的危险因素，而每天饮酒（OR=0.93，95%CI:0.89～0.98）、农村居民（OR= 0.84，95%CI:0.81～0.86）、年龄≥80岁（OR=0.76，95%CI:0.73～0.79）是血脂异常的保护因素。见表2。
3　讨论
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郫都区老年人血脂异常检出率30.3%，低于中国65岁以上老年人血脂异常meta分析结果（47.0%）[8]及张家港市、重庆市、广东省、沈阳市等相关报道[9-14]，推测原因可能有：地区经济社会发展水平及人群健康意识有差异，成都市郫都区为国家慢性病综合防治示范区，政府出台慢性病防治、“三减三健”措施较多；不同研究中，人群城乡分布、样本量、男女比例、年龄分布有差异；本研究体检对象为自愿参与体检的老年人，配合社区老年人健康管理工作，自身对健康情况较为重视，可能日常会采取相对健康的生活方式，可能导致估计的血脂异常患病率偏低。
女性血脂异常的可能性比男性高48%（OR=1.48，95%CI:1.43～1.54），这与全国18岁以上成年人结果相反[15]，但与重庆市渝北区、广东省等针对老年人群的报道一致[11-13]。可能原因与老年女性绝经期激素变化有关，绝经期后脂质代谢受影响，从而影响血脂水平[16]。提示应进一步重视老年女性血脂水平及血脂升高易发的动脉粥样硬化、冠心病等心脑血管疾病[2-3]。本研究中女性HDL-C降低的可能性比男性低63%（OR=0.37，95%CI:0.34～0.39），这也与重庆市、广东省报道一致[11-12]，具体原因有待进一步研究。
70～79岁和≥80岁老年人血脂异常患病风险较60～69岁分别低12%（OR=0.88，95%CI:0.86～0.91）和24%（OR=0.76，95%CI:0.73～0.79），与陈曾丽等人[8]纳入样本量10万与人的meta分析结果一致，可能与老年人衰老程度加深相关。一是随着年龄增长，老年人进食总量可能降低；二是老年人胃肠道消化吸收能力随着年龄增加逐渐降低，且肝细胞合成脂质及转运脂质入血能力降低，导致血脂异常患病风险降低。
本研究中不锻炼的老年人比每天锻炼的老年人血脂异常患病风险增加了18%（OR=1.18，95%CI:1.14～1.22），这与胡佳康等人[17]的研究相吻合，缺乏运动锻炼，影响血脂代谢，致血脂指标异常。本研究中吸烟增加患血脂异常的风险，这与以往的报道相一致[18-20]，可能原因是烟草中大量的尼古丁、焦油和吸烟过程中形成的过量一氧化碳，均会加速游离脂肪酸生成，引起血脂代谢紊乱。城市居民血脂异常检出率高于农村，与全国2010年[21]、2011年[22]的两项研究吻合，也与北京、广东等地[14，23-24]调查结果一致，可能与城乡居民饮食习惯、身体活动量不同有关。
饮酒对血脂的影响目前结论不一，在本研究中，饮酒是TC升高的危险因素（OR=1.18，95%CI:1.10～1.26）、是HDL-C降低的保护因素（OR=0.55，95%CI:0.50～0.61），其中每天饮酒是血脂异常的保护因素（OR=0.93，95%CI:0.89～0.98）。刘峥等人[25-27]的研究得到了类似结果，可能原因为：一是适量饮酒与HDL-C升高有关，然而本研究未涉及饮酒量及饮酒品种分析，还需进一步研究；二是血脂异常患者改变了饮酒习惯，也值得进一步探究。
超重、肥胖老年人血脂异常的检出风险分别是消瘦老年人的1.97倍（OR=1.97，95%CI:1.80～2.16）和2.05倍（OR=2.05，95%CI:1.86～2.26），这与深圳市等地[11，25]报道一致，亦有研究表明BMI与血脂异常之间存在的非线性剂量-反应关系[12]。有研究报道，中心性肥胖是血脂异常的危险因素[24，28]，本研究也有相同结论（OR=1.23，95%CI:1.19～1.27）。提示血脂异常与超重肥胖、中心性肥胖息息相关，肥胖者胰岛素抵抗会减少LDL-C含量，并降低脂蛋白脂酶活性，二者将引起极低密度脂蛋白胆固醇、TC、LDL-C等清除障碍，从而诱发一系列脂质异常改变[29]。
综上，成都市郫都区老年人整体血脂异常检出率低于全国平均标准。建议对老年人血脂进行性别差异化管理，尤其重视女性血脂变化；对老年人进行超重肥胖及中心性肥胖相关的健康教育，强化老年人体重管理，每日锻炼、戒烟限酒；强化基层卫生服务，在辖区增设血脂快速检测点，方便居民随时监测血脂。
本研究具有一定的局限性。一是本次调查为横断面研究，无法论证影响因素与血脂异常因果关联；二是本次研究对象为自愿参与体检的老年人，配合社区老年人健康管理工作，自身对健康情况较为重视，可能导致估计的血脂异常患病率偏低；三是膳食行为的问卷过于简单且带有较强主观性，致使膳食行为判定为良好者占99.1%，在本研究中未得出有意义结论。
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2025年第52卷第11期
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doi: 10.20043/j.cnki.MPM.202503018
  • 接收时间：2025-03-01
  • 首发时间：2026-03-18
  • 出版时间：2025-06-10
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  • 收稿日期：2025-03-01
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    成都市郫都区疾病预防控制中心，四川 成都 611730

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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